Search PubMed⌕ Search

Biomedical subjects

F J Ten Kate

Publications and source records attributed to F J Ten Kate.

30 records · Page 2Linked to original sources

Differential diagnosis of inflammatory bowel disease. A comparison of various diagnostic classifications.

Fifty consecutive patients with inflammatory bowel disease of the colon who presented at the University Hospital Rotterdam/Dijkzigt were assessed by four methods: clinical diagnosis, criteria defined by Lennard-Jones and by the Organisation Mondiale de Gastroenterologie (O.M.G.E.) scoring systems, and histologic slide review. All cases were classified into three diagnostic groups: established Crohn's disease (CD), indeterminate colitis, or definite ulcerative colitis (UC). The classifications were compared by kappa analysis. Eighteen of the 50 patients were classified as having established CD by the O.M.G.E. scoring system and Lennard-Jones criteria; 17 were so classified by clinicians, and only 8 by histologic slide review. The agreement among clinician's diagnosis, Lennard-Jones criteria, and the O.M.G.E. scoring system was good (Fleiss-Cohen-weighted kappa; p less than 0.001). Agreement among histology, Lennard-Jones criteria, and the O.M.G.E scoring system was less good (p less than 0.05) and not significantly associated with clinical diagnosis. Histology was less prone to diagnose established CD or established UC and more likely to diagnose indeterminate colitis. This study has shown that the systems of disease definition set out by Lennard-Jones and the O.M.G.E. are comparable and agree well with each other and clinicians's diagnosis, but biopsy specimens have a limited diagnostic value in disease differentiation in inflammatory bowel disease.

Colitis↗

Morphometrically estimated variation in nuclear size. A useful tool in grading prostatic cancer.

At present there are several grading systems for prostatic carcinoma. Most are difficult to reproduce. An objective method of grading seems to be necessary and could make comparisons between various groups of patients easier and grading more reliable. In the present study morphometrically estimated nuclear size and variation in nuclear size are matched with the survival rates of 207 patients who underwent total perineal prostatectomy for cancer. On the basis of morphometrically estimated variation in nuclear size the patients could be divided into two groups with significantly differing survival rates. In this way it was possible to split the group of patients with grade 2 carcinoma (Mostofi's grading system) into two groups of patients with significantly different survival rates. The survival rates in these two groups did not differ significantly from those in the patients with Grade 1 and Grade 3 tumors respectively. The results are discussed in the light of the recent literature on the subject. Morphometry seems to be a valuable tool in grading prostatic cancer.

Cell Nucleus↗

Histological grading of prostatic carcinoma in prostatectomy specimens. Comparison of prognostic accuracy of five grading systems.

The prognostic accuracy of 5 histological grading systems (Broders, Anderson, Mostofi, Gleason and Mostofi-Schroeder) was compared. Grading was performed on 50 prostatectomy specimens by 5 pathologists. The results were averaged so as to reduce the impact of inter-observer variation. The Cox proportional hazards model was used to estimate the relationship between average grading scores and both time-to-recurrence and time-to-death by prostatic carcinoma. Age at surgery was considered to be a possible confounding factor and adjusted accordingly. The prognostic impact of the 5 grading systems (related to both recurrence and death caused by prostatic carcinoma) was judged by the likelihood ratio (LR) test score (chi 2 distributed with 1 df); for time-to-recurrence for the Mostofi-Schroeder score the LR was 6.54 and for the Gleason system it was 1.79. A stepwise procedure demonstrated that the best prognostic performance was reached with the Mostofi-Schroeder and Broders systems used together (with Mostofi-Schroeder weighted 1.5 times larger than Broders). For time-to-recurrence the median grading result was also used, giving results similar to the mean grading result. For time-to-death from prostatic carcinoma the LR test scores for all grading systems were relatively low. In this analysis the outcome of the Gleason system showed a minimum of prognostic ability, whereas the Broders and Mostofi-Schroeder systems had a reasonable predictive ability. Since the inter-observer variation of the Mostofi-Schroeder system was large, the Broders system is preferable. The restrictions and implications of this study are discussed and a brief review of the prognostic importance of grading of prostatic carcinoma is presented.

Aged↗

Cholangiocarcinoma associated with multiple bile-duct hamartomas of the liver.

The case of a 61-year-old woman with a surgically resected solitary cholangiocarcinoma of the liver is reported, where many discrete multiple bile duct hamartoma (MBDH) were also seen. The latter is a congenital lesion of the liver that potentially may be confused with widespread metastatic disease. The relationship between cholangiocarcinoma and MBDH was studied histologically by the use of an immunoperoxidase technique for cytokeratin. MBDH was strongly positive for cytokeratin, while the neoplasm showed this to a lesser extent, but a clear continuity between the MBDH epithelial cells and those of the neoplasm was demonstrated by the use of this technic. The potential use for the various cytokeratins in the differentiation of primary from secondary liver tumors, is discussed. This differentiation is a significant problem to the pathologist. Although cholangiocarcinoma may, on occasion, be associated with various congenital lesions of the bile ducts, the association with MBDH is extremely rare, this being only the third reported case.

Adenoma, Bile Duct↗

Severe stenotic scar contracture of the Microvel Hemashield right-sided extracardiac conduit.

We report 2 patients who developed severe scar contracture of a Microvel Hemashield valveless right-sided extracardiac conduit implanted 14 months earlier. In both cases, the diameter of the conduit was reduced along its entire length, with the prosthetic material plicated inward by retraction and organization of connective fibrous tissue on either side of the conduit.

Blood Vessel Prosthesis↗

Histological lesions associated with cyclosporin: incidence and reversibility in one year old kidney transplants.

To determine the type and reversibility of the long term effects of cyclosporin A, biopsy specimens were taken from 20 recipients of kidney allografts, twelve months after transplantation, and three months later, during which time azathioprine was substituted for cyclosporin A. Arteriolar IgM and complement deposits and tubular isometric vacuolisation associated with cyclosporin A treatment significantly regressed after stopping this drug one year after transplantation. Conversion to azathioprine was accompanied by an increase in mononuclear cell infiltrates and tubulitis despite an evident improvement in renal function. Nephrotoxicity as a result of cyclosporin A is common but can be reversed--at least partially.

Arteries↗

Differentiation antigens in fetal human pancreas. Reexpression in cancer.

An antiserum was raised against pancreatic extracts obtained from human fetuses under 5 months of gestational age. After absorption with adult tissues, this antiserum specifically recognized antigens located in the cytoplasm of fetal pancreatic acini. All of the examined pancreatic tissues, ranging from 3 to 5 months of gestational age, showed a strong positive reaction of most of the acinar cells. The number of stained acini and the staining intensity gradually decreased from 5 months onwards and by the 7th-8th month only a few cells remained positive. Adult pancreas was completely negative as were a variety of normal adult and fetal tissues. This antiserum also reacted with tumor structures in 18/18 pancreatic adenocarcinomas as well as with pancreatic acini in the vicinity of tumor. Primary carcinomas of the liver, large bowel, stomach, breast, urinary bladder, lung and other localizations did not react with this antiserum. In some cases of chronic pancreatitis (3/12) a reaction was observed in a few acinar cells. Immunoblot assay after polyacrylamide electrophoresis revealed, in both fetuses and tumors, two main antigens of approximately 60 kDa and 110 kDa relative molecular weight. Several minor components were also observed. These results suggest that our polyclonal antiserum defines a new group of oncodevelopmental antigens with high organ specificity.

Adenocarcinoma↗

Pathologic explanation for postoperative obstipation in Hirschsprung's disease revealed with monoclonal antibody staining.

Until now, no pathologic explanation could be found for the postoperative obstipation occurring in some patients with intestinal aganglionosis. Twenty-two of 108 infants treated for intestinal aganglionosis suffered from postoperative obstipation. Resected material from these 22 patients and from 17 control subjects was investigated with monoclonal anti-neurofilament antibody staining. An abnormal staining pattern was revealed in 18 of the constipated patients. Consequently, this new immunohistochemical staining technic has revealed a hitherto unsuspected cause for postoperative obstipation in aganglionosis. The monoclonal antibody may provide early warning of such postoperative constipation.

Antibodies, Monoclonal↗

Intraperitoneal toxicity of Hytrast: an experimental study.

The toxic effects of Hytrast were studied on the peritoneum of laboratory rats in order to define the lethal dose and possible causes of toxicity. The results show that Hytrast, due to its toxicity, should not be used in any clinical situation where gastrointestinal tract perforation or leakage is a possibility.

Abdomen↗

Auxiliary transplantation of a partial liver graft in the dog and the pig.

Auxiliary, heterotopic transplantation of 60% of the liver was performed in 24 beagles and 24 pigs. Operative mortality was low and graft survival was greatly improved by DLA-matching in the dog. The graft supplied by arterial and portal blood gave excellent metabolic support after the host liver was rendered ischemic by six hours clamping of the hepatic artery.

Animals↗

Immune complex detection by immunofluorescence on polymorphonuclear leucocytes.

Polymorphonuclear leucocytes (PMN) from patients with systemic lupus erythematosus (SLE) were isolated from defibrinated and heparinized blood. In addition, PMN from a healthy donor were incubated with sera from SLE patients and with sera containing artificially prepared immune complexes of hepatitis B surface antigen (HBsAg) and human anti-HBsAg immunoglobulin (anti-HBs) with well defined variations of the antigen/antibody ratio. To one group of blood samples, 5 mM monoiodine acetic acid (MIAA) was added to block in vitro phagocytosis. The Pmn were examined for the presence of IgG, IgM, and HBsAg by the immunofluorescence technique. PMN from defibrinated blood of SLE patients showed in up to 80% immunoglobulin (Ig)-inclusions. However, addition of 5 mM MIAA reduced the number of Ig-containing PMN to at most 40%, which levels were equal to numbers found in specimens from heparinized blood. Addition of 5 mM MIAA to heparinized blood did not reduce the number of PMN with Ig inclusions. Normal donor PMN isolated from defibrinated, heparinized, and EDT blood showed equal amounts of Ig inclusions after incubation with SLE sera, but none when MIAA had been added. In PMN incubated with HBsAg-anti HBs immune complexes with an antigen antibody ratio between 5 and 0-2, both HBsAg and IgG could be detected. It is concluded that Ig inclusions in PMN from heparinized blood from SLE patients are due to in vivo phagocytosis, presumably of circulating immune complexes. In vitro phagocytosis of Ig from SLE sera by normal donor PMN also suggests the presence of immune complexes. Dependent on the antigen-antibody ratio, artificial HBsAg/anti-HBs immune complexes can be detected by in vitro phagocytosis by PM.

Antigen-Antibody Complex↗